The role of boost in hypofractionated irradiation after breast-conserving surgery

Abstract

Adjuvant radiotherapy after surgical treatment constitutes an indispensable part of breast-conserving therapy (BCT) in early breast cancer. The standard dose to the whole breast in BCT is 50 Gy delivered in 2 Gy fractions, with or without a boost dose to the tumour bed. A decreased risk of local recurrence, particularly in younger patients, as a result of a boost dose has been confirmed in a large randomised trial. Recently, mildly hypofractionated schedules of radiotherapy are being used more frequently in BCT. The indications and form of boost radiotherapy in hypofractionated schedules have not been fully determined. This article reviews randomised trials addressing hypofractionated radiotherapy in BCT, and particularly the role of a boost dose. We also present current recommendations in these areas.